TYLER WESLEY STULL LCPC CADC NPI 1407446636

NPI Information

NPI: 1407446636
Provider Name: TYLER WESLEY STULL, LCPC CADC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
1200 W STATE ST
ROCKFORD, IL
ZIP 61102
Phone: (815) 490-1600
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Tyler Wesley Stull, LCPC CADC is a mental health counselor in Rockford, IL. Tyler Wesley Stull, LCPC CADC NPI is 1407446636. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1200 W STATE ST
ROCKFORD, IL
ZIP 61102-112
Phone: (815) 490-1600
Fax: (815) 490-1881

The NPI 1407446636 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 1/21/2021 and was last updated on 2/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	29194	ILLINOIS	No
2	101YM0800X	Counselor	Mental Health	180.011338	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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